We have shown that transesophageal dobutamine stress echocardiography is a useful and safe technique for the assessment of patients with coronary artery disease. The purpose of this study was to determine whether this technique can identify stenoses of individual vessels in patients with coronary artery disease. For this purpose, 62 patients (53 female; age 61plus/minus10 years) were included in the study. The left ventricle was visualized by means of transesophageal echocardiography and stress was induced by infusion of dobutamine with stepwise increases. The left ventricle was divided into 16 segments and each segment was assigned to a major coronary artery. New or worsening wall motion abnormalities during dobutamine infusion developed in 55 of the 62 patients (sensitivity 89%). The sensitivity and specificity of the technique to detect individual stenosis was as follows: left anterior descending artery 83% and 73% respectively; left circumflex artery 82% and 93% respectively; right coronary artery 78% and 86% respectively. No significant differences were observed in the sensitivity or specificity with which the technique was able to predict disease of individual vessels, although there was a trend toward a lower specificity in the territory of the left anterior descending artery. These findings indicate that, among patients with coronary artery disease, transesophageal dobutamine stress echocardiography is an accurate method for assessing the distribution of significant stenoses of individual vessels.